Mama at the Bar: Using Analogies to Understand Targeted Therapies
By Patricia (Pat) Kelly, DNP, APRN, CNS, AGN-BC, AOCN®
Analogies and visuals are powerful learning tools. If you’re one of the many nurses whose eyes glaze over when approaching genomics, consider connecting the “omics” concepts to interpretative visuals, clinical practice, and everyday life examples to enhance your learning and make the concepts more relevant to you. Here’s an example of how it can be done.
Several years ago, I heard ONS member Wendy Vogel, MSN, FNP, AOCNP®, discuss targeted therapies in a memorable way. When Wendy explained targeted therapies, I felt as if I had put on eyeglasses and could now see clearly. It made sense, and I could visualize the drugs in action. Wendy gave us permission to share her “Mama at the Bar” analogy with the caveat that her examples are simplistic and not exact science, but it does help nurses and others understand. (Editor’s note: The analogy was originally published in the 2011 ONS Genetics Special Interest Group coordinator’s message and has been updated to reflect the current state of targeted therapies.)
Mama at the Bar
Think of the cell as the bar and the receptor sites and ligands as people in the bar who want to interact and hook up. The receptor sites and ligands get together for a lot of lovin’ in the cell nucleus, resulting in excessive cellular growth and proliferation. Mama is the targeted therapy, and she wants to stop the lovin’ communications.
Mama may try to intercept you and take you home at several places in the bar scene and often uses more than one strategy to stop the lovin’. If Mama gets you in the parking lot, she is working extracellularly like bevacizumab: hooking up with a ligand, preventing the ligand from getting to the receptor site, and blocking the vascular endothelial growth factor.
Mama may also bind you up and try to stop you from going through the bar door (cell membrane), like how trastuzimab and cetuximab work. Those targeted drugs connect to the receptor site before the natural ligand does.
If you make it all the way into the bar (intracellular) and Mama gets you there, she tries to interrupt your crazy bar talk with other customers by using multitargeted therapy such as dasatinib, encorafenib, sorafenib, or bortezomib.
These are only a few of the targeted therapies that block cellular pathways. Consult the National Cancer Institute for an updated list of approved targeted therapies organized by cancer site.
Mama is a great analogy! I will never think of these targeted therapies, the monoclonal antibodies (-mabs), multikinase inhibitors (-nibs), and proteosome inhibitors (-mibs), again without thinking of Mama. We can learn more effectively when we infuse images, analogies, and humor.